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Almaja Lekshmi*, Sowparnika Treasa Sabu and Prof. (Dr). Shaiju S. Dharan


Statins are a class of cholesterol lowering agents that act by inhibiting the enzyme HMGCoA reductase which catalyzes the rate limiting step in cholesterol biosynthesis. The first statin to be discovered was named as compactin, but lovastatin became the first statin to be approved within the USA by Food and Drug Administration. Statins are associated with pleiotropic effects like anti-inflammatory, immunomodulatory, endothelial function, antioxidant, antiatherogenic and antithrombotic effects. Even though the benefit outweighs the risk, there are some adverse effects that include statin associated muscle symptoms, liver abnormalities, diabetes, cognitive impairments, cataracts and cancer. Some patients are not able to continue statin therapy due to certain adverse reactions. Alternative therapies are used in such statin intolerant patients that include switching to another statin, using intermittent statin dosage regimen or prescribing statins on alterative days or on once weekly dosage regimen, non statin lipid lowering drugs, new hypolipidemic drugs, mipomersen, microsomal triglyceride transfer protein, life style modifications, LDL apheresis and use of red yeast rice.

Keywords: Statins, pleiotropic effects, adverse effects, alternative therapies.

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